Chronic lymphatic congestion
will result in poor oxygenation
and it’s just a poor sense of well-being.
It increases the risk of infection,
could increase mortality,
may increase healing time
in that when you have congestion
the tissue isn’t bathed in healthy tissue.
You’re not getting a replenishment
of the fluids
and it’s just not a healthy situation.
It can cause increased fibrosis
when you don’t have a return
of lymphatic fluids into the circulation
and a good flow.
And it could decrease the effectiveness
because you don’t get the medication
getting to the area where it’s needed.
You don’t want the medication to stay
in the circulatory system.
You want it to get out into the tissues.
So, let me go back to the case.
We have a 3-year-old male
who is brought to the office by his
mom with difficulty breathing,
wheezing for 3 hours.
What are the sympathetic and
that the lung is becoming inflamed
and what’s going on here?
Well, we know that the sympathetic
system is having an effect.
It’s causing mucosal irritation
and it could lead to infection
or worsening of infection,
or decreased ability to
fight off infection.
It tells you which areas are more prone
to having problems.
If you have a prolonged sympathetic tone,
you can have vasoconstriction
that’s going to lead to hypoprofusion
in the lung.
And prolonged sympathetictonia
can lead to epithelial hyperplasia
and swelling because you’re not having
good return and good fluid flow.
Hypersympathetic effects lead
which is meant to be a protective mechanism.
And vasoconstriction and tissue congestion
will decrease oxygenation of lung tissues.
On the parasympathetic side,
the alveoli are going to fill with fluid
and that’s the Hering-Breuer reflex mechanism.
And you can’t distinguish within the lung
whether it’s air or fluid there
which is going to impede
oxygenation of the body.
The vagus nerve is what’s going to
let the respiratory center know
that the excursion is not going well,
and when you need more air.
And that becomes a sense
of discomfort in the body.
Concurrently, the carotid bodies are
telling the body what needs to be done
so you have more oxygenation,
And it is going to affect diaphragmatic
functioning as well,
particularly the diaphragmatic
And the parasympathetic can lead to shallow,
So when you are treating somebody
with a pulmonary problem,
even though it’s pulmonary initially,
there are a lot of effects that you
can have a positive effect on.
You can start treating the muscles
and the viscerosomatic findings
that you have
is that breathing becomes easier.
And there are techniques that
are better tolerated
and work better because somebody
who is having difficulty breathing
is not going to want to lie down flat.
Their survival mechanism is saying
sit up straight, lean forward,
work those accessory muscles to help out.
It’s going to stress and strain
the accessory muscles
but it’s also going to put
the person in a position
where they feel that they are
So you want to avoid techniques
that put them in an uncomfortable
There are also techniques that will address
the hypersympathetic tone
and will help balance that
so the patient can get to a system
of ease and functioning.
And you want to know which techniques
you can do comfortably
to help with lymphatic flow.
Your goal is to increase venous
and lymphatic flow,
improve the arterial supply to the lungs,
and ease the spasm that is
going on in the lung
because the secretions tend to
be a spiral downward
that decrease the area of
oxygenation in the lungs.
And the phlegm is not always helpful.
While it may block or give an area
of a biofilm to fight off infection,
it doesn’t allow for air exchange.
So you want to do what you can to
decrease the workload of breathing
and ease the efficiency of
The OMT that you’re doing,
again, I like to do it in a seated position
because that’s where people are comfortable.
I want to work on thoracic compliance
and balance sympathetic tone.
You may want to work on myofascial
Muscle energy is also good.
Strain, counterstrain is another
technique that is well tolerated.
And you want to make sure
that you are working on easing
the muscles of respiration
and allowing the thoracic spine, thorax,
and the ribs to work in tandem.
Another very common treatment done
on people who are having trouble
breathing is rib raising.
That is usually early in the cycle
and when people start to have an attack,
or when you have no other
options available to you.
On somebody who’s in extremis,
you can lay them down,
if they will tolerate that,
and do rib raising
to help with the expansion of the thorax
and exchange of air.
When you want to do OMT to address
you want to start in the suboccipital
area with the suboccipital release.
It’s an area where you tend
to have congestion
and an acute problem can become chronic.
OA decompression is a good thing to do.
And myofascial treatment to the upper
cervical region is also helpful.
Balance ligamentous tension
is another treatment
that can be helpful particularly
in the upper cervical area.
If you want to help lymphatic return,
doming of the diaphragm is something
that is commonly done
where you have the patient lay down and
you are able to palpate the diaphragm.
You find the area of the diaphragms
where they are having restrictions
and you just try and help find
the area of dis-ease
and enhance the motion.
I hope you find this helpful
in thinking about
health and illness in patients
and where you can make a difference
when a patient’s having issues,
both minor and severe.
Because in the osteopathic concept
of the body being a single unit,
the fascia and lymphatic systems
are critical concepts
in how this happens
and what you need to do
to help a patient stay healthy.